Ulcerative Rectosigmoid Langerhans Cell Histiocytosis Mimicking Late-Onset Inflammatory Bowel Disease (ACG 2026) - Aug 29, 2026 - Abstract #P3614; Pres time: Oct 12, 2026; 10:30 AM - 04:15 PM; Location: Exhibit Halls A - D (Level 3); "She had a history of indeterminate colitis diagnosed in 2023 with patchy colonic and small bowel involvement requiring multiple targeted immune modulating (TIM) therapies including vedolizumab, Risankizumab, infliximab, adalimumab, and azathioprine...On admission, she was found to have a Clostridium difficile infection and was started on fidaxomicin with clinical response...The patient was re-started on targeted LCH therapy with dabrafenib by hematology and nutritional support via total parenteral nutrition...B: On higher magnification, the lamina propria contains patchy histiocytic infiltrates, which are accompanied by scattered eosinophils and are in close association with colonic crypts with crypt injury, cryptitis and crypt abscesses (hematoxylin-eosin stains at 200x). C: CD1a immunohistochemistry is strongly and diffusely positive in the histiocytic infiltrates, supporting the diagnosis of Langerhans cell histiocytosis (CD1a stain, 200x)."
CNS Disorders • Endocrine Disorders • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Hematological Malignancies • Immunology • Infectious Disease • Inflammation • Inflammatory Bowel Disease • Langerhans Cell Histiocytosis • CD1a
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Emma Terwilliger MD 1; Geoff J. Thomas MD 2; Leticia Assad Maia Sandoval MD 1; Pierce Claassen MD 3; Taylor Viggiano MD 2; Davyani Rozera MBBS 4; Stacey Rolak MD 1; Amani Elshaer MBBS 5; Marcela Salomao MD 2; Mashal J. Batheja MD 2; Anna Silverman MD 2; Christina Ha MD FACG 2
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